GPs' perspectives on diagnostic testing in children with persistent non-specific symptoms: a qualitative study
Lianne Jw Mulder1, Sophie M Ansems1, Marjolein Y Berger1
1Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, the Netherlands.
Summary
General practitioners (GPs) consider factors beyond diagnosis when deciding on diagnostic tests for children with persistent non-specific symptoms (PNS). Their decisions are influenced by medical, psychosocial, and resource considerations, differing from adult patient care.
Area of Science:
- Pediatric healthcare
- General practice
- Diagnostic decision-making
Background:
- Diagnostic testing is common for children with persistent non-specific symptoms (PNS).
- Both under- and over-testing have negative consequences.
- GP perspectives on testing in children with PNS are under-researched.
Purpose of the Study:
- To explore General Practitioners' (GPs) views on diagnostic testing decisions in children with PNS.
- To compare these perspectives with GPs' motives for testing adults.
Main Methods:
- Qualitative study using semi-structured interviews with Dutch GPs.
- Thematic content analysis of transcribed interviews exploring real-life cases.
- Purposive sampling until data saturation.
Main Results:
- Twelve GPs participated, revealing decision-making influenced by medical, psychosocial, consultation management, and resource utilization factors.
- GPs were more hesitant to test children due to vulnerability, lower organic disease probability, and reduced autonomy.
- Motivations for testing extended beyond diagnostic uncertainty, similar to adult care.
Conclusions:
- GPs' diagnostic testing decisions in children with PNS are complex and multifactorial.
- Interventions and guidelines should address these broader influencing factors.
- Understanding these perspectives can inform strategies to optimize testing practices.
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